What is Cord Prolapse?
Cord prolapse is a rare but serious obstetric emergency where the umbilical cord descends into the vagina ahead of the presenting part of the fetus. This condition can lead to fetal hypoxia due to cord compression, and it requires immediate medical intervention to prevent adverse outcomes.
Causes of Cord Prolapse
The primary causes of cord prolapse include abnormal fetal presentation such as breech or transverse lie,
polyhydramnios, a high fetal station, and multiple gestations. Additional risk factors include preterm labor, low birth weight, and premature rupture of membranes.
Symptoms and Diagnosis
The hallmark symptom of cord prolapse is the sudden onset of fetal bradycardia, which is a drop in fetal heart rate. In some cases, the cord may be visibly protruding from the vagina. Diagnosis is typically made through a combination of physical examination and
electronic fetal monitoring.
Management and Treatment
Once cord prolapse is diagnosed, several immediate actions must be taken to relieve pressure on the cord and maintain fetal oxygenation. These include positioning the mother in a
knee-chest position or Trendelenburg position, and manual elevation of the presenting fetal part. An emergency cesarean section is usually required to deliver the baby as quickly as possible.
Preventive Measures
Preventive measures are generally aimed at recognizing and managing risk factors early. For example, careful monitoring of high-risk pregnancies, judicious use of amniotomy, and ensuring that delivery facilities are prepared to handle obstetric emergencies can reduce the incidence and impact of cord prolapse.
Prognosis
The prognosis for the baby largely depends on the speed and effectiveness of the intervention. Prompt delivery often results in a favorable outcome, but delays can lead to severe complications such as hypoxic-ischemic encephalopathy or even fetal death. Maternal prognosis is generally good, but the emotional impact of the emergency situation can be significant.
